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Triple Therapy May Become New First-Line Treatment for Mesothelioma

ByAlex Strauss
First-Line Treatment for Mesothelioma

A combination of three powerful mesothelioma therapies could become a new first-line treatment for mesothelioma if an upcoming clinical trial is successful.

The makers of the experimental immunotherapy drug ONCOS-102 announced the new clinical trial. It will enroll up to 100 mesothelioma patients from around the world. 

The trial will test ONCOS-102 along with Keytruda (pembrolizumab) and standard chemotherapy. Keytruda is an immune checkpoint inhibitor. Both ONCOS-102 and Keytruda have shown some promise when combined with mesothelioma chemotherapy.

Targovax hopes that the triple therapy approach will produce an even more powerful first-line treatment for mesothelioma.

Clinic Trial of ONCOS-102

A first-line treatment is a treatment for mesothelioma patients who have not yet had any other therapies. Most patients start with chemotherapy with Alimta. But chemotherapy damages healthy cells along with cancer cells. This limits how much medicine doctors can give which can limit its effectiveness.

ONCOS-102 is special because it can target mesothelioma cells while leaving healthy cells alone. ONCOS-102 is made from a genetically modified virus that recognizes mesothelioma cells. When the virus gets inside the cells, it replicates itself many times over. This triggers an anti-cancer immune response. Norweigian drug maker Targovax produces ONCOS-102.

Tragovax released the early results of a Phase I/II clinical trial of ONCOS-102 in May. The trial tested ONCOS-102 along with chemotherapy as both a second- and a first-line treatment for mesothelioma patients who were not candidates for surgery. The results showed that it helped the chemotherapy work better. 

When Targovax released those findings, the company hinted that it might soon run a trial with another big drug company. Now, we know which company it is. 

Immunotherapy + Chemotherapy for First-Line Treatment of Mesothelioma

The drug maker involved in the new trial is New Jersey-based Merck and the drug is pembrolizumab (Keytruda). Keytruda is an immune checkpoint inhibitor.

Keytruda has also been the subject of tests as a first-line treatment for mesothelioma. Studies show that it helps some patients live longer when combined with chemotherapy. But it is only approved for mesothelioma patients who overexpress a protein called PD-L1. PD-L1 helps mesothelioma cells avoid immune system attack. Keytruda blocks that action. 

ONCOS-102 stimulates the immune system. It may also raise the level of PD-L1 in mesothelioma cells. Adding Keytruda might counter that effect and make ONCOS-102 even more powerful. 

“We believe the clinical immune activation data we have seen so far provide a strong scientific rationale for adding anti-PD-1 checkpoint blockade to the ONCOS-102 and chemotherapy combination in mesothelioma,” says Øystein Soug, CEO of Targovax.

New Trial Will Start Enrolling Within a Year

Up to 100 patients will enroll in the new trial in the US and Europe. These patients will receive either ONCOS-102, Keytruda, and chemotherapy or just Keytruda and chemotherapy as a first-line treatment for mesothelioma. This means patients cannot have had other treatments. 

Targovax says several cancer centers have expressed interest in the new trial. They hope to start enrolling patients within 12 months. 

“We are hopeful that the combination of ONCOS-102, pembrolizumab and chemotherapy will lead to improved outcomes for patients with this challenging disease who currently have few treatment alternatives,” says Soug. 

Sources:

“Targovax announces collaboration to evaluate ONCOS-102 in combination with KEYTRUDA® in mesothelioma”, June 23, 2020, News Release, Targovax website, https://www.targovax.com/en/targovax-announces-collaboration-to-evaluate-oncos-102-in-combination-with-keytruda-in-mesothelioma/

“Targovax releases update for mesothelioma trial combining ONCOS-102 and chemotherapy”, Targovax News Release, May 4, 2020, Targovax website, Accessed May 28, 2020, https://www.targovax.com/en/targovax-releases-update-for-mesothelioma-trial-combining-oncos-102-and-chemotherapy/

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